‘It is only in recent years that the issue of disability has been transformed from a purely medical problem to a political one, in Britain, at least. Central to this transformation has been the rise of the disability movement.’ (Oliver and Zarb 1989, 221)
The epigraph to this chapter makes two claims that are symptomatic of the ones made by writers who support a social model of disability. Firstly, it claims that historically disability has been seen as a medical problem rather than a social one. The second claim is that the change from a medical to a social problem has been achieved through political action by the disability movement, a phenomenon generally regarded as existing only for the last 30 years. This chapter will challenge the accuracy of both these claims.
Social model theorists portray disability purely in terms of two opposing models. They suggest that traditional intellectuals understand disability as a medical and individual problem. The dominance of medicine and the conception of disability as an impairment has, they argue, been the cause of oppression for disabled people.
According to Oliver (1990) this served to reinforce an individual model of personal tragedy. This view is presented in opposition to the emancipatory potential of the organic understanding of disability contained within the social model. If it can be shown that historical evidence does not support such a belief then the philosophy of opposing models at the core of the social model becomes unsatisfactory.
Claims for a historical continuity of oppression
Elizabeth Bredberg (1999), an academic historian, has criticised some authors who write on disability for constructing historical accounts which proclaim to expose evidence of disabling social practices without sufficient regard for the sources they cite. She calls into question the use of ‘prevalent proof’ as a reliable source for historical writing (192-93). This practice involves making a claim that is unsupported by empirical evidence but which then becomes regarded as factual and is repeated by many other authors because it supports a particular ideology.
Reviewing Colin Barnes’ ‘A Legacy of Oppression’ (Barnes 1997), Bredberg
comments on some factual errors and issues cautions about his use of historical texts to support present day claims of disabling practices. Her criticisms include the
inappropriate use of biblical texts such as the Book of Leviticus and Barnes’ spurious claims about the infanticide of impaired children in ancient Greece which he bases on Plato’s Republic. Bredberg points out that there is no actual evidence to support Plato’s claims that infanticide was routinely practiced by the state as Plato’s Republic was an idealized and imaginary one (197-98). Hence claims of evidence of disabling practices from historical sources are dubious and ideological adopting a politically advantageous slant that effectively labels disabled people in the pre-1970s disability movement as merely reactive recipients of oppressive practices.
A consideration of Finkelstein’s (1981) claims that disability is principally the
product of industrialisation further supports Bredberg’s criticism of ‘prevalent proof’. Finkelstein asserts that prior to industrialisation disabled people were included in work in a predominantly agrarian society but were excluded as industrialisation occurred. Apart from the claim itself there is little supporting evidence in his account
and no explanation of why this was the case. Similarly, Oliver’s (1990) historical account is heavily influenced by the role of institutions and their increased function as a means of state control. Oliver draws here on the work of Foucault (amongst others) to exemplify the relationship between individuals and institutional practices. It could be said that this style of historical review allows an impression to emerge whereby disabled people are largely regarded as passive recipients of oppressive practices which they unquestioningly accept. Such historical accounts portray disabled people as tragic victims which helps to add weight to claims that the social model of
disability is a new one that offers emancipation from oppressive traditional
intellectual understandings of the causes of disability. In other words, these accounts support a political ideology of the present by selecting secondary source data from the past and interpreting this against a discursive backcloth of present day understandings.
This chapter challenges the claims made by Barnes (1997) and others by examining how, historically, some impaired people have organised themselves to resist the traditional intellectual perceptions of disability and have actively influenced legislation with the aim of achieving economic emancipation and social change.
This chapter addresses a number of themes in order to answer the following questions:
Has legislation always reinforced a singularly medical approach to disability?
Is the organisation of politically active groups of disabled people fighting for emancipation through social change a new phenomenon?
Was disability overcome by treating impairments (a medical approach) or by changing attitudes and environments (a social model approach)?
Legislation will be used as a benchmark for determining traditional intellectual formulations because dominant understandings of the causes of disability are likely to become embedded in statute and may be translated into policy. An example of how legislation can influence the way traditional understanding is determined can, perhaps, best be seen in race and gender equality legislation.
If inequality in organisations between white males, women and ethnic minorities was biologically determined (that is, if white males had some biological superiority which made them more suitable employees than the other groups) then legislation on the grounds of sex and race discrimination in employment could not have been introduced. Although traditional formulations of gender roles were based on biological determinism with the rise of the second wave feminist movement, such stereotypes were challenged and alternative reasons provided for the under- representation of women in employment. These included the failure to apply meritocratic principles in recruitment and promotion decisions. The passing of the Sex Discrimination Act (1970) and the Equal Pay Act (1975) was therefore a shift in understanding generated by organic intellectuals in the feminist movement. Whether the relevant legislation has succeeded in overcoming discrimination is a discussion outside the scope of this research. However, what is evident is that legislation could be introduced based on the understanding that, in these cases, discrimination was structurally and ideologically created rather than biologically determined.
Despite the claims of social model theorists, the same kind of argument is difficult to apply to disabled people. Whilst there is no doubt that historically medical definitions
did inform understandings of disability, it is also the case that some social causes were also acknowledged. The Disability Discrimination Act (1995) requires that access to buildings is improved, and employers are expected to make reasonable adjustments to include impaired people in work (Doyle 1996a, 1996b, 1996c; Gooding 1996). If disability was thought only to be caused by an individual’s impairment it would surely be logically inconsistent to suggest disability could be overcome by any means other than correcting deficits in the impaired body.
Earlier chapters discussed the idea that the term ‘disability’ has inherent definitional problems depending on the position one takes regarding its cause. Hence when reviewing historical documents, it is not possible to determine definitively the meaning of the term. However, from as far back as the Elizabethan Poor Laws of 1601 legislation has generally relied on a common group characteristic of specified impairments as the criterion for determining those who fall within the remit of the Acts. This could be used to argue in support of the claim that disability has always been viewed as a medical problem (Finkelstein, 2001). However, on the other hand, it can also be argued that using impairment as a group identifier merely represents a practical means of determining group membership. To avoid imposing present day definitions onto uncertain historical meanings as far as possible the stable identifier of impairment specific groups as constituting disabled people will be used.
The chapter commences by reviewing one such impairment specific group - the blind -and examines how the attendant disability experienced by the blind was viewed from the beginning of the last century. The analysis is restricted to the blind for a number of reasons: the researcher has a personal interest in this specific group; access to the records of Henshaw’s Society had been negotiated, and the first
organised trade union of disabled people was the National League of the Blind (NLB) founded in 1899 (Yates 1999). Certain legislation passed before this date has been reviewed because it can provide an insight into how traditional intellectual formulations of disability were influenced by the State before any influence was possible from the NLB. The State is today cast as representative of traditional intellectual formulations of disability.
The politics of disability
In the early 1870s widespread economic depression caused rising levels of
unemployment and, as the effects of the depression eased, the economic imperative for the State was to reduce levels of unemployment across the working population (Jones and Novak 1999, 118). This drive affected blind people in addition to non- impaired unemployed workers. From the time of the Elizabethan Poor Law of 1601 the State had defined blindness in relation to the ability to perform work (HMSO 1951) and subsequent administrations had continued to regard all disabled people in relation to their ability to engage in paid work (Beveridge 1906).
In 1886 a Royal Commission entitled, A Report on the Blind and Dumb (Wagg 1932, 63) investigated the circumstances in which blind people lived. The Commission interviewed 6,000 blind people and found that a lack of education and training resulted in many being unable to find work whilst those in work had predominantly low status and low paid jobs. Reporting in 1889, the Commission recommended compulsory education for blind children between the ages of 5 and 16 in either schools or special institutions. These recommendations became law in the Education of Blind and Deaf Mute Children (Scotland) Act (1890) and the Elementary
aimed at increasing the incidence of blind people in the workforce. Here, a social rather than medical approach is obvious as the remedies suggested were not related to solving the problem of impairment itself, rather to improving work opportunities through education and training. Although these measures were aimed at improving the social conditions under which blind people lived it was also the case, however, that medical interventions were being researched to prevent or correct many forms of visual impairment (Wagg 1932, 180-84).
The Commission’s recommendations included:
Schools should provide training for blind people between the ages of 16 and 21 who wished to learn a trade. This did not directly translate into law, although under the Secondary Education Act (1920) local authorities were asked to supply education other than elementary.
To ensure work for this newly-skilled blind population workshops were to be established in every large centre of population, which did not already possess such a facility. The committee urged that these were supported by private charity rather than through state funds.
For people blinded between the ages of 21 and 50 training was to be supplied by the schools with the person either gaining employment from home
working or in the workshops of the institutions. The implication of this was that for those over the age of 50, training for employment was not considered necessary.
The Blind Persons Act (1920) reinforced a definition that related impairment solely to the ability to work. The Act defines a blind person as, ‘to be so blind as to be unable to perform any work for which eyesight is essential.’ Under the Old Age Pensions Act (1908) the retirement age for a blind person was reduced from 70 to 50 and duties were placed on local authorities to provide workshops, hostels, homes or other suitable unspecified provision for the benefit of the blind. Although the obligation was on the local authority to provide workshops and accommodation many met their duties by sub-contracting the provision to established charities (HMSO 1951).
Thus, three strategies were employed by the state. The first was the use of medical intervention to prevent or cure the condition, an approach supported by some blind organic intellectuals (The New Beacon 1950, 88). Secondly, increased opportunity was provided for education, training and work and thirdly, the acceptance that as blindness increased in the general population in relation to age (Dodds 1993; Duckett and Pratt 2001; Henshaw’s 1928) reducing the age of retirement also reduced the need for the provision of training and employment places for those acquiring blindness in later life.
The increase in education and training coupled with the compulsory expansion of the workshop sector increased the employment rate of blind people (HMSO 1951). However, the arbitrary retirement age was set to fall once more, this time in line with a general reduction across the working population. The Old Age Pensions
Amendment Act (1936) brought retirement age down to its current level of 60 for women and 65 for men, although this is currently under review. The Blind Persons’ Amendment Act (1938) lowered the age at which blind people could receive the old age pension to 40 years. Whilst the qualifying definition of blindness expressed in the Blind Persons Act (1920) remained the same, section 2 of the Blind Persons
Amendment Act (1938) contained the following addition:
In determining in the case of any blind person whether or not or to what extent to provide financial assistance under the preceding conditions the council take into account not only the needs of the blind person but also the needs of any members of the household of which the blind person is a member, who are dependent on him.
From these legislative definitions it is proposed that, historically, a three stage model of disability can be discerned:
Impairment is rooted in sensory lack
Loss of work opportunity results from the consequences of impairment (the necessity of eyesight for certain jobs)
Social disadvantage is recognised through the provision of financial support for those incapable of work.
This model bears a striking resemblance to the socio-medical model framed some 60 years later (WHO 1980) but which social model adherents classify as a medical model. The present legislation in the form of the Disability Discrimination Act (1995) can therefore be argued to represent a historical continuity in the
understandings of disability. In other words, it has been consistently recognised that there are some consequences to impairment which disable; that disability can be reduced by altering social factors including improved education, training and work opportunities, and that financial assistance should be provided for those who cannot work.
Traces of socio-medical models can be found in other legislation including The Blind Voters Act (1933). This was effectively an amendment to Section 26 of the Ballot Act (1872) and was inserted into this Act as Section 26a:
the presiding officer shall require the voter to declare orally whether he is so incapacitated by his blindness as to be unable to vote without assistance and if he is satisfied that the voter is so incapacitated a companion will be allowed to assist.
The Blind Voters Act (1933) determines incapacity clearly within medical discourse: it is the impairment which does not enable the individual to vote as others do.
However, the remedies for overcoming the consequences of impairment lie in social responses: allowing a helper to assist. Moreover, the impairment is not related to any medical or work-based criteria; in effect it is self-defining. The disabling barrier for
appropriate voting box. Considering the date and available technologies, it would be difficult to imagine any other method that could allow all eligible blind people to exercise their democratic rights.
Braille was invented in 1828 and first introduced in the UK in 1868 (Wagg 1932, 16) and would appear to have offered one solution which could have provided equal access to the ballot box. However, this would have required all blind voters to read Braille, a situation which does not even pertain in the present day. Out of an estimated visually impaired population of 1.5 million in the UK today there are only
approximately 10,000 Braille users. According to the RNIB (1999) reasons for the low usage of Braille include:
The reluctance of elderly recently blind people to learn a new skill
The limited availability of Braille material
The bulk, size and cost of the material
Hence the social changes allowed under the Blind Voters Act (1933) could be regarded as a pragmatic solution to the problem of maximising the number of blind people enabled to participate in the democratic process.
Two principles have emerged from this examination of legislative definitions in relation to models of disability. First of all, ‘disability’ as a term was not present in legislation during the period examined but ‘impairment’ - a medical criterion - was the word used to determine qualification under legislation. Secondly, when remedies to reduce disabling effects were sought there was no predominance of medical influence, instead definitions revolved principally around the ability to work. In this
regard, when it was recognised that many blind people were excluded from work due to the lack of social provisions, social and structural changes were attempted such as the provision of education, training and workshops intended to improve employment opportunities for blind people. Political and legislative actions were, to varying degrees, aimed at the removal of structural barriers.
As discussed at the beginning of this chapter, many present day historical accounts of disability portray disabled people as tragic victims of oppressive medical practices (Finkelstein 2001; Barnes 1997; Oliver 1990) and state that the current disability movement was instrumental in changing this situation. But is this actually the case? Have disabled people historically been passive recipients of dominant discourses? In the following section it is suggested that such a view of history cannot be sustained by illustrating how blind people were proactive in changing the social environment.
Disabled people as victims of medical discourse
It would be incorrect to imply that legislation was the sole instrument that influenced the lives of blind people. Blind people themselves effected social change through political activity and by promoting educational provision. In other words, they fit Gramsci’s notion of organic intellectuals who generated a form of good sense. Blind people could be assisted to engage in society not by attempting medical interventions to cure impairment but by altering social conditions to allow impaired people greater social inclusion in society. In effect, such people constituted the first activists in an embryonic disability movement.
In 1791, Edward Rushton, a blind poet, founded the first teaching college for the blind named The Liverpool School for the Indigent Blind. This was 79 years before
Education Act 1870 (HMSO, 1951). It can be argued that some blind children were given access to education before many non-impaired peers received equal access.